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聚乙二醇干扰素α-2b联合利巴韦林用于治疗既往未接受治疗的丙型肝炎病毒2型或3型感染的慢性丙型肝炎患者。

Peginterferon alfa-2b plus ribavirin for treatment of chronic hepatitis C in previously untreated patients infected with HCV genotypes 2 or 3.

作者信息

Zeuzem Stefan, Hultcrantz Rolf, Bourliere Marc, Goeser Tobias, Marcellin Patrick, Sanchez-Tapias Jose, Sarrazin Christoph, Harvey Joann, Brass Clifford, Albrecht Janice

机构信息

Department of Medicine, Saarland University Hospital, Homburg/Saar, Germany.

出版信息

J Hepatol. 2004 Jun;40(6):993-9. doi: 10.1016/j.jhep.2004.02.007.

Abstract

BACKGROUND/AIMS: Treatment duration in patients with chronic hepatitis C in the era of standard interferon-alpha plus ribavirin was tailored according to hepatitis C virus (HCV) genotype: patients infected with HCV-1 were treated for 48 weeks, patients infected with HCV-2/3 for 24 weeks. The aim of the present study was to investigate this schedule for HCV-2/3 infected patients in the era of pegylated interferon-alpha plus ribavirin.

METHODS

Patients chronically infected with HCV-2 (n=42) or HCV-3 (n=182) were treated with peginterferon alfa-2b 1.5 microg/kg subcutaneously once weekly plus ribavirin 800-1400 mg/day based on body weight for 24 weeks.

RESULTS

The end of treatment (EOT) and sustained virologic response (SVR) was higher in patients infected with HCV-2 (100 and 93%, respectively) than in patients infected with HCV-3 (93 and 79%, respectively). Baseline viremia (P=0.020), treatment duration >16 weeks (P<0.001) and steatosis (<5%, P=0.015) were significant independent predictors of SVR. Adverse events resulted in discontinuation in 5% and dose reduction in 22% of patients.

CONCLUSIONS

Treatment for 24 weeks with peginterferon alfa-2b and ribavirin is sufficient in HCV 2 or 3 infected patients. The lower SVR in patients infected with HCV-3 compared with HCV-2 infected patients may be related to higher levels of steatosis in this population.

摘要

背景/目的:在普通干扰素-α联合利巴韦林时代,慢性丙型肝炎患者的治疗疗程根据丙型肝炎病毒(HCV)基因型进行调整:HCV-1感染患者接受48周治疗,HCV-2/3感染患者接受24周治疗。本研究的目的是在聚乙二醇化干扰素-α联合利巴韦林时代,探讨针对HCV-2/3感染患者的这一治疗方案。

方法

对42例HCV-2慢性感染患者和182例HCV-3慢性感染患者,皮下注射聚乙二醇化干扰素α-2b 1.5μg/kg,每周1次,联合基于体重的利巴韦林800 - 1400mg/天,治疗24周。

结果

HCV-2感染患者的治疗结束时(EOT)和持续病毒学应答(SVR)率(分别为100%和93%)高于HCV-3感染患者(分别为93%和79%)。基线病毒血症(P = 0.020)、治疗疗程>16周(P<0.001)和脂肪变性(<5%,P = 0.015)是SVR的显著独立预测因素。不良事件导致5%的患者停药,22%的患者减量。

结论

聚乙二醇化干扰素α-2b和利巴韦林治疗24周对HCV 2或3感染患者足够。与HCV-2感染患者相比,HCV-3感染患者较低的SVR可能与此人群较高的脂肪变性水平有关。

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